- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a diligent and detail-oriented Post Review Nurse to perform ... + Perform other duties as assigned. Essential Skills + Utilization management and utilization review experience. + Acute care expertise. + Knowledge of… more
- Penn State Health (Hershey, PA)
- …medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** RN Registered Nurse Utilization Management Specialist - Utilization ... for maintaining compliance with the CMS Conditions of Participation for Utilization Management . **MINIMUM QUALIFICATION(S):** + Bachelors Degree in Nursing… more
- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a dedicated and skilled Post Review Nurse to join our ... + Perform other duties as assigned. Essential Skills + Strong background in utilization management , utilization review , and medical policy. + Proficiency… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem ... Registered Nurse II/III - Utilization Management ...as needed to assist with patient care coordination and utilization review . The incumbent will be responsible… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, ... organization, professional organizations, and community health care facilities concerning Utilization Management . + Participates in in-services and continuing… more
- CVS Health (Austin, TX)
- …occasionally per the need of the department.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant...in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more
- CVS Health (Topeka, KS)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review… more
- CVS Health (Santa Fe, NM)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... hospitalization and intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior authorization. +… more
- CVS Health (Phoenix, AZ)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- McLaren Health Care (Pontiac, MI)
- **Department:** Utilization Management **Scheduled Bi-Weekly Hours:** 80 **Daily Work Times:** 11:00am to 7:00pm-On site **Position Summary:** Responsible for ... care environment _Preferred:_ + Bachelor's degree in nursing + Experience in utilization management /case management /clinical documentation, critical care, or… more
- University of Washington (Seattle, WA)
- …Description** **UW Medical Center - Montlake** has an outstanding opportunity for **a Utilization Management Nurse .** **POSITION HIGHLIGHTS** The goal of the ... ** Utilization Management (UM) Nurse ** is to ensure delivery...for maintaining the knowledge and skill set related to utilization review , care coordination, and performance improvement,… more
- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a dedicated Post Review Nurse to join our Utilization ... duties as assigned. Essential Skills + Experience in utilization management and utilization review . + Knowledge of medical policy and InterQual criteria.… more
- Omaha Children's Hospital (Omaha, NE)
- …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative,...Compact State Licensure Required and + RN-BC - Case Management Nurse Preferred Children's is the very… more
- Omaha Children's Hospital (Omaha, NE)
- …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... a wide variety of settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative, flexible, risk taker. **Licenses and… more
- CVS Health (Little Rock, AR)
- …+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + Must have experience using MS Office + Must be willing ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- AmeriHealth Caritas (Washington, DC)
- …BONUS** **Role Overview:** Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- CDPHP (Latham, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- CVS Health (Little Rock, AR)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
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